Deck 14: Oral Cavity and Gastrointestinal Tract

Question 1

This slide shows the muscle layer of a stomach that was removed from a 60-year-old man who complained of dyspepsia and bleeding. The tissue section was taken from the muscle underneath a large prepyloric ulcer. Which of the following is the most likely diagnosis?

A) Peptic ulcer disease
B) Helicobacter pylori-related gastritis
C) Autoimmune gastritis
D) Hyperplastic gastropathy
E) Adenocarcinoma

Answer 1

Adenocarcinoma

Question 2

Nonbacterial gastroenteritis in adults presenting with nausea, vomiting, watery diarrhea, and abdominal pain in most instances is caused by

A) astrovirus
B) Norwalk virus
C) rota virus
D) enteric adenovirus
E) poliovirus

Answer 2

Norwalk virus

Question 3

Crohn disease is most often diagnosed in which age group?

A) 5-10 years
B) 15-25 years
C) 40-50 years
D) 60-70 years
E) Older than 80 years

Answer 3

15-25 years

Question 4

In adults, which part of the intestine is most often involved in volvulus?

A) Jejunum
B) Ileum
C) Cecum
D) Transverse colon
E) Sigmoid colon

Question 5

Basal zone hyperplasia exceeding 20% of the thickness of the esophageal epithelium, accompanied by elongation of lamina propria papillae and by inflammatory infiltrates that contain eosinophils is a histologic finding most typical of which disease?

A) Reflux esophagitis
B) Viral esophagitis
C) Barrett esophagus
D) Mallory-Weiss syndrome
E) Boerhaave syndrome

Question 6

Angiodysplasia causing lower intestinal bleeding is most often located in the

A) jejunum
B) ileum
C) cecum
D) transverse colon
E) rectum

Question 7

Polyps of Peutz-Jeghers syndrome are best classified as

A) serrated adenomas
B) hyperplastic polyps
C) tubular adenoma
D) villous adenomas
E) hamartomas

Question 8

Protein-losing gastroenteropathy will most likely develop in patients who have

A) acute erosive gastritis
B) chronic Helicobacter pylori-related gastritis
C) autoimmune atrophic gastritis
D) hypertrophic gastropathy
E) gastric peptic ulcer

Question 9

Carcinoma of the esophagus most often presents on gross examination as a

A) polypoid exophytic lesion
B) flat induration of the mucosa
C) volcano-like excavated lesion
D) diffuse narrowing of the esophageal lumen
E) linitis plastica

Question 10

Esophageal diverticulum located above the upper esophageal sphincter is called

A) congenital diverticulum
B) postinflammatory diverticulum
C) traction diverticulum
D) epiphrenic diverticulum
E) Zenker diverticulum

Question 11

The finding of anti-endomysial antibodies in a person with intestinal malabsorption strongly favors the diagnosis of

A) Whipple disease
B) celiac sprue
C) tropical sprue
D) lactase deficiency
E) abetalipoproteinemia

Question 12

Which cells in the intestines are the precursors of carcinoids?

A) Goblet cells
B) Enterocytes
C) Paneth cells
D) Neuroendocrine cells
E) Stromal cells

Question 13

A 60-year-old man who complained of persistent right lower quadrant pain underwent an appendectomy. The appendix appeared globular and dilated due to an obstruction by a fecalith. It was filled with mucus. Histologically, the cavity was lined with normal appendiceal mucosa; there was no evidence of neoplasia. This lesion most likely represents a

A) mucocele
B) mucinous cystadenoma
C) mucinous cystadenocarcinoma
D) pseudomyxoma peritonei
E) pseudocyst

Question 14

This figure shows a portion of the mesentery and omentum removed during a work-up of a 60-year-old woman with ascites and large multicystic ovarian masses. The lesions seen here are most consistent with the diagnosis of

A) primary peritoneal benign tumor
B) primary peritoneal malignant tumor
C) metastatic carcinoma
D) metastatic sarcoma
E) lymphoma

Question 15

T-cell lymphoma was diagnosed in a 55-year-old man who had a lengthy history of intestinal disease. Which of the following diseases most likely preceded this malignancy?

A) Celiac disease
B) Whipple disease
C) Crohn disease
D) Abetalipoproteinemia
E) AIDS

Question 16

Which intestinal malabsorption syndrome is accompanied by a complete absence of chylomicrons, very-low-density lipoproteins, and low-density lipoproteins in plasma?

A) Crohn disease
B) Celiac sprue
C) Tropical sprue
D) Lactase deficiency
E) Abetalipoproteinemia

Question 17

Most gastric polyps are microscopically classified as

A) tubular adenomas
B) villous adenomas
C) hyperplastic polyps
D) fundic gland polyps
E) carcinoids

Question 18

Primary tumors of the peritoneum are called

A) adenocarcinomatosis peritonei
B) pseudomyxoma peritonei
C) peritoneal sarcoma
D) mesothelioma
E) myxomatosis

Question 19

Autoimmune atrophic gastritis and pernicious anemia are most often associated with

A) Helicobacter pylori infection
B) peptic ulceration of the duodenum
C) Ménétrier disease
D) Hashimoto thyroiditis
E) trichobezoars

Question 20

This esophageal carcinoma developed in a 65-year-old man who had reflux esophagitis for 15 years. Most likely this tumor was histologically classified as

A) adenocarcinoma
B) squamous cell carcinoma
C) transitional cell carcinoma
D) basal cell carcinoma
E) oat cell carcinoma

Question 21

This slide illustrates the lesions seen in the partial colectomy specimen obtained from a 78-year-old man who has chronic constipation, left lower quadrant pain, and fever. On cross section, this sigmoid colon shows changes most consistent with the diagnosis of

A) Crohn disease
B) toxic megacolon
C) carcinoma of the colon
D) carcinoid
E) diverticulitis

Question 22

This small intestinal lesion was removed from a 56-year-old woman and is most likely a

A) tubular adenoma
B) hamartoma
C) carcinoma
D) sarcoma
E) pseudopolyp